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December 20, 2023Pathogens and ImmunityOpen Access

Arterial Stiffness and Oxidized LDL Independently Associated With Post-Acute Sequalae of SARS-CoV-2

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Key result

Patients with post-acute sequelae of SARS-CoV-2 had significantly worse arterial elasticity compared to uninfected controls, with a mean difference in augmentation index of 11.21.

Why the study?

Post-acute sequelae of SARS-CoV-2 (PASC) presents with different phenotypes among COVID-19 survivors, but its underlying etiology remains elusive.

Does SARS-CoV-2 infection and PASC increase arterial stiffness and endothelial dysfunction in adult patients?

Population

379 COVID-negative and COVID-positive participants with and without PASC

Comparison

COVID-negative controls vs COVID-positive participants with and without PASC

Design

Prospective propensity score-matched cohort study

Authors

SZSokratis N. ZisisJDJared DurieuxCMChristian Mouchati

Discussion

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Overview

Endothelial function testing may aid PASC phenotyping in survivors; leaves open causality and need for prospective trials.

Study Design

Type

Cohort (n=379)

Multicenter

No

Structured PICO

Does SARS-CoV-2 infection and PASC increase arterial stiffness and endothelial dysfunction in adult patients?

P
Population
379 prospectively enrolled adults, including 217 COVID-negative controls and 162 convalescent COVID-19 patients, assessed for endothelial function and arterial elasticity.
E
Exposure
SARS-CoV-2 infection with or without Post-Acute Sequelae of SARS-CoV-2 (PASC)
C
Comparator
COVID-negative controls (uninfected participants with negative SARS-CoV-2 antibody test and no prior history of COVID or acute respiratory illness since December 2019)
O
Outcome
Endothelial function (measured by reactive hyperemic index [RHI]) and arterial elasticity (measured by augmentation index standardized at 75 bpm [AI]) using the EndoPAT devicesurrogate

Main Result

Mean Difference: 11.21

Absolute Event Rate: 11.4% vs 0.18%

p-value: p=<0.0001

Post-acute sequelae of SARS-CoV-2 (PASC) is independently associated with increased arterial stiffness and elevated oxidized LDL, suggesting a role for oxidative stress and vascular changes in long COVID.

Limitations

  • Possibility of residual confounding despite propensity score matching
  • Peripheral arterial tonometry results could have been affected by unmeasured confounders
  • Assessment of reactive hyperemia was limited to one of many functions of vascular endothelium
  • Cross-sectional design does not allow for observation regarding clinical consequences
  • Peripheral arterial tonometry results could be affected by unmeasured confounders
  • Assessment of reactive hyperemia limited to one of many functions of vascular endothelium
  • Cross-sectional design does not allow for observations regarding clinical consequences

Cite This Study

Zisis et al. (2023) conducted a cohort in Post-Acute Sequelae of SARS-CoV-2 (PASC) (n=379). SARS-CoV-2 infection with PASC vs. COVID-negative controls was evaluated on Arterial elasticity (augmentation index) (MD 11.21, p=<0.0001). Patients with post-acute sequelae of SARS-CoV-2 had significantly worse arterial elasticity compared to uninfected controls, with a mean difference in augmentation index of 11.21.

synapsesocial.com/papers/6a6f5dc78031ec7bb1dbb691https://doi.org/10.20411/pai.v8i2.634
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Persistent Endothelial Dysfunction in Post-Acute COVID-19 Syndrome: A Case-Control Study2021 · 104 citations
  2. 2Arterial stiffness and wave reflection: Biomarkers of cardiovascular risk2009 · 229 citations
  3. 3Assessment of Arterial Stiffness, A Translational Medicine Biomarker System for Evaluation of Vascular Risk2008 · 105 citations
  4. 4Assessing Endothelial Vasodilator Function with the Endo-PAT 20002010 · 165 citations
  5. 5Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline2021 · 659 citations